Volume 3 Issue 5 News from the Department of Family and Social Medicine June/July 2007 STFM in Chicago Welcomes Society of Teachers of Family Medicine, 40th Annual Spring Conference, Chicago, IL, May, 2007. Amy Yosha (Miglani), FM '05 and Emily Jackson, FM '06 compare notes on their reproductive health fellowships on different coasts. And Farewells Welcome! (Belated) To Niko Verdecias as the Project Director for our HRSA Special Projects of National Significance-funded program to improve the oral health of people with HIV. Niko comes to us from SUNY Downstate where she was the Project Coordinator for the entire Women's Interagency HIV Study. Niko has a background in HIV/AIDS, health disparities, urban and immigrant health, and chronic disease research. She received her MPH from SUNY Downstate and a BS in Psychology from Syracuse University. Niko has experience in project and research planning and execution, as well as manuscript development and publication. The Department's educational leadership, fellows and faculty enjoying dinner together at one of Chicago's oldest Italian restaurants. PRESENTIONS Barr W, See S. Research in a Community-based Residency Program: Developing a Curriculum Under the New RRC Guidelines. Fornari A, Duggan M, Korin E, Dempster J, Polisar M. Developmental and Competency Performance Assessment: A Resident Evaluation Form Assessing Competency for Patient Care/Medical Knowledge. Godfrey E, Rubin S, Smith E. Integration of Early Abortion Services Into Primary Care: Perspectives From Patients at an Abortion Clinic. Niko will be working with many of you as we collaborate with the Dental Department and MMG to bring a mobile dental van on line as part of the integrated primary care and oral health services at the MMG2 sties. Gold M, DasGupta S. Cinema and the Speculum: Using Popular Film Clips to Teach Patient-centered Language and Behavior. Niko can be reached at (718) 920-6357 or via e-mail at [email protected]. Gold M, Kumar V, Wu J. Learning to Listen to Ourselves: Teaching Patientcentered Language in Reproductive Health. Inside Gross P. Do Our Stories Have the Power to Change Health Care? Gutman I, Blum C, Jackson E. Pregnancy Options Counseling. Welcomes/Farewells Academic Presentations RPSM Alumni Message Board 2007 RPSM Winning Abstracts Quote of the Month Divisional Highlights Departmental Publications Schedule Highlights NY’s Top Doctors Family Medicine Kligler B, Maizes V, Lowdog T, Saper R. An Internet-based Curriculum in Botanical Medicine for Family Medicine Residents. Lesnewski R, Rubin S, Miller S. Well Woman Exam. Mockler G, Painter K, Kirchen N. Improving Counseling and Prescription of Emergency Contraception With the EMR Versus an Educational Seminar. Nosal S, Prine L. Using the Electronic Health Record in a Clinical Trial. Continued on page 2 -1- table of contents 1 1/2 2 3 3 4/5 4/5 6 6 6 Presentations continued from page 1 Olagundoye O, Whiting C, Witt D, Lebensohn P, Rodgers D, Moreno C, Johnson M, Monroe A, Townsend J, Cash C, Mouton C, Gonsalves W, Hazel L. “Career Narratives” Faculty Development By Sharing, Reflecting, and Planning Career Paths. Pollard T, Andazola J, Ellert W, Forman S, Garvin R, Gebhard R, Kumar KA, Patterson D, Prine L, Sicilia J. Fun With Procedures! Learn How to Effectively Teach Procedures in Your Practice. Prine L, Gold M, Goodman S, Thiry-Zaragoza M, Stulberg D, Delendorf C, Rubin S, Hadley S, Kumar V, Sawires P, Moore K. Teaching Women’s Reproductive Health Care. Prine L, Sicilia-May J, Gillespie G, Kumar V, Gold M. Skills for Procedure Training-Faculty Development in IUD Insertion. Prine L, Nosal S, Canon M, Miller S. Oral Contraceptive Pills—Over the Counter? Stulberg D, Paige J, Waxman NJ. Patient-centered Contraceptive Care and Evidence-based Practice: An Odd Couple? Williams R. Curriculum for an Urban Family-centered Maternity Care Fellowship. Pediatric Academic Society, Annual Meeting, Toronto, Canada, May, 2007 RPSM ALUMNI MESSAGE BOARD News from Present and Past From Brian Selland, FM 1990 The Bronx, rural North Dakota and “urban” Alaska...When it comes to health care, these three places have a lot more in common than one would imagine. I am now enjoying a “sabbatical” of sorts in Anchorage, Alaska that has included some parttime work in a community health center. In all three places I am amazed at how universal the needs are for good primary care, and how well my training prepared me to work in all of these settings. The Family Health Center and the Anchorage Neighborhood Health Center (ANHC) have much in common, with immigrants from all over the world settling in the neighborhoods around the clinic, and having limited access to health care. In Anchorage, a city of about 250,000, the ANHC is the only clinic in town that takes care of the uninsured, takes new medicare patients and offers comprehensive care for HIV and homeless patients. Needless to say, the clinic is short on space, long on patients and is a challenging place to work. Like the practice in rural North Dakota, a major problem is recruiting and retaining family physicians. I am enjoying being part of the Friends and Alumni of the RPSM committee. The meetings are by national teleconference, and it is fun to “hear voices” from the past. There are several things the committee has already accomplished. One is to provide the means for RPSM alumni and friends to reconnect and stay connected to whatever extent we wish through the internet. Another, and for me the most important, is to provide the opportunity for alumni and friends to support RPSM efforts to recruit and train future family physicians. As I look down the road, I wonder and worry about who will take care of our patients when we start cutting back or stop practicing? All efforts to support RPSM as well as other recruiting and training programs are an investment in the future of our patients to have “First Class Medical Care for All People.” Harris J, Giddy J, Thomas M. QI: HIV Testing of the Children of Adult Patients in a HIV Treatment Program. Tesher M, Siegel S, Sharif I, Campbell D. Resident Knowledge and Confidence about Breastfeeding in a Poor Urban Community. Harris J, O’Connor K, Sharif I. Legal Needs Assessment of Families Accessing Care at an Inner-City Community Health Center. Scharbach K, Sharif I, Skae CC. Resident Knowledge and Comfort with Pediatric Pain Management. Sharif I, Wills TA, Sargent JD. Does Television Viewing during MiddleSchool Lead to Poorer School Performance. -2- Congratulations to all RPSM Graduates for 2007! Listed below are the winning abstracts of graduating residents who were presented with social medicine project awards at the RPSM Graduation, held at Maestro’s Caterers, June 23, 2007. FAMILY MEDICINE Catherine DeGood, DO *Winner Chairman’s Research Award Abortion in Primary Care A Needs Assessment Survey of Female Patients. A descriptive survey to assess the acceptability and desirability of early abortion provision at a residency-based family medicine office. Ana Matos, MD & Denise Reyes, MD *Winner Distinction in Research Award Voluntary Counseling and Testing and the HIV Partner Notification Project in Guatemala The Guatemalan Health Law mandates a system for notification of partners of HIV-positive patients. This project followed in the footsteps of former resident Dr. Amy Miglani and was under the guidance of Dr. Matt Anderson. It included the feasibility of beginning a partner notification system in Guatemala and the pilot of a pre- and post-voluntary counseling and testing questionnaire to assess risk factors, effectiveness, and risk behavior change inpatients presenting for HIV testing. SOCIAL PEDIATRICS Jamal Harris, MD *Winner Distinction in Research Award Quality Improvement: HIV Testing of the Children of Adult Patients in a HIV Treatment Program During the summer of 2006, we conducted a quality improvement project to enhance family based care at Sinikithemba, the HIV/AIDS care program at McCord Hospital in Durban, South Africa. The project included revising the family care page with the introduction of an electronic version and a focus on the testing of children. To complete the project we conducted a retrospective chart review, staff interviews, focus groups, and staff trainings. Kathryn Scharbach, MD *Winner of Chairman’s Research Award Development of a Pain Management Curriculum for Pediatric Residents Inadequate treatment of pain has been a problem in children. Racial and ethnic minorities are at risk for problematic access to pain care and poor pain assessment, and often receive nferior treatment for their pain complaints. The goal of this project was to expand the “Pain Curriculum” for pediatric residents at CHAM. A survey was conducted among Pediatric Housestaff to assess: knowledge about and comfort with managing pain, perceived barriers to pain management, and preference for learning methods. Based on the results of this survey a morning lecture, two case conferences and an EBM session were created – these educational sessions were conducted in collaboration with the Pediatric Palliative Care Service and the Pediatric Pain Service. Finally, a post survey will be distributed to test the effectiveness of a pain management curriculum on improving knowledge & confidence. SOCIAL INTERNAL MEDICINE/PRIMARY CARE Aaron Fox, MD *Winner of Chairman’s Research Award Perceptions of health and housing in an unstably housed HIV infected population HIV-infected individuals, particularly those with unstable housing situations, have difficulty maintaining adequate access to health care. 14 semi-structured interviews were conducted with HIV-infected residents of single room occupancy (SRO) hotels in New York City. The interviews established detailed timelines related to housing status and health care following HIV diagnosis. For most individuals, diagnosis of HIV was followed by a period of chaos, which often included loss of housing, escalating drug use, and worsening self-care behaviors. Competing priorities negatively affected health care. The need for housing resulted in frequent moves, which disrupted continuity of medical care, and food insecurity impeded adherence with medications. Ultimately, when considering health care for HIV-infected marginalized populations, housing must be addressed as a vital component. Homer Venters, MD *Winner of Dan Leicht Award Bringing Primary Care to Legal Aid CHCC clinic is located within one block of the Bronx Defenders, a legal aid agency that represents 12,000 criminal defense clients per year. For 2 1/2 years, we have collaborated in assessing the need for primary care services among Bronx Defenders clients. One medical resident has spent over 200 hours at Bronx Defenders helping clients with medical questions, reestablish prior medical care or for those who wish, come to CHCC for medical care. The horizon leans forward, offering you space to place new steps of change - Mary Angelou -3- Divisional highlights and more Division of Education By Drs. Janet Townsend and Alice Fornari Education Division Hosts Visiting Professor Dr. Patricia A. Carney is a Professor of Family Medicine, and the Associate Director for Population Studies at the OHSU Cancer Institute at Oregon Health Sciences University in Portland, Oregon. At the end of May, Dr. Carney spent two days visiting the Department of Family and Social Medicine. During this time, Dr. Carney acted as the Education Visiting Professor for the HRSAsupported Health Disparities Faculty Scholarship Retreat where she mentored and consulted on individual projects being conducted by the AAU Health Disparities Faculty Scholars. Reflecting on her experience with contributions to more than 100 publications, Dr. Carney presented an informative talk on "Manuscript Development: The Pitfalls and Pleasures." The following day, Dr. Carney shared her experience, with the entire department, as an evaluator for the P4 Project in her Grand Rounds talk on "Preparing the Personal Physician for Practice (P4): Opportunities for Innovation & Discovery." In addition to presenting, Dr. Carney facilitated meetings with faculty members on resident July orientation month manuscripts, and evaluations methods for the Health Disparities Scholarship Program. RECENT PUBLICATIONS Congratulations! To Drs. Arthur Blank and Sean O’Mahony on the publication of Choices in Palliative Care which brings together 31 leading experts to spotlight core issues in the field, and identifies ways palliative care can fill gaps in the current care system. The book defines palliative care as an interdisciplinary and integrative discipline, providing links among patients, family, and doctors. The book is written for public health administrators, planners, teachers, and policy makers. Visit www.springer.com for information on purchasing this book. (See below for a list of departmental faculty publications included in this book.) Blank A, O’Mahony S, Selwyn A, eds. Choices in Palliative Care: Issues in Health Care Delivery. New York: Springer, 2007. Chapters included from departmental faculty: - Cheville A, Khemka V, O’Mahony S. The role of cancer rehabilitation in the maintenance of functional integrity and quality of life. - Myers S, Blank A. Palliative care and quality management: the core principles of quality improvement and their utility in designing clinical programs for end-of-life care and complex case management models. - O’Mahony S, Martino-Starvaggi F. Palliative care and the elderly: complex case management. - Rainone F, McHugh M. Patient-centered palliative care in the home. - Rhodes-Kropf J. Palliative care for patients with alzheimer’s dementia: advanced care planning across transition points. - Selwyn PA, Robinson L, Dale MG, McCorkle R. HIV/AIDS and palliative care: models of care and policy issues. Fundraising Campaign: Larry Bauer, Chief Executive Officer of the Family Medicine Education Consortium (FMEC) and Project Director of the Academic Fundraising Fellowship, co-sponsored by the Society of Teachers of Family Medicine (STFM) and FMEC, visited the Department on May 4-5 as a consultant to our “Make a Difference” Development Campaign. Mr. Bauer held several meetings with small groups and individuals and presented at the Leadership Group and All-Faculty Meeting. He also met with members of the DFSM Development Campaign Committee. Highlights from his presentation are: - - Philanthropic donations in the US represent an enormous pool of potential resources to support work that we do, far in excess of the small pool of HRSA/AHRQ/CDC dollars for which we usually compete. The DFSM/RPSM/HCOE/BronxCREED all do essential and valuable work that would be attractive to many donors. - We need to think big and have clarity of vision about what we want to accomplish. If we articulate important ideas, the money will follow. - We need to take advantage of every possible venue to make known our work and our vision. Using the metaphor of a house, Mr. Bauer said we need “front porches, doors and windows” to provide access, a view of the external world and Other departmental publications continued on page 5 Continued on page 5 -4- Division highlights continued from page 4 Continued from page 4 routes for communication. Other Departmental Publications - Projects that convene and engage new community and academic partners will ultimately be more relevant, more successful and more likely to attract a donor. Braganza SF, Larkin M. Riding high on energy drinks. Contemporary Pediatrics. 2007: 24(5):61-73. - Connecting strategies such as hosting breakfasts to present project ideas and stories of successful projects, participating with visibility at community events (such as the Bronx Tour bike ride), and convening meetings of key stakeholders to discuss new proposals to address community health needs are essential building blocks in the relationships that will lead to significant donations. - We are all connected to a network of friends, relations and acquaintances who may share our interests and are in turn connected to others with similar interests. Among these networks (and not too distant from us) are persons with influence and means to support out work. We are counting on your continued contributions of ideas and connections to help make our campaign a success. Please respond to the recent e-mail soliciting ideas for programs we would establish if we had a donor willing to contribute $500,000. These will be used to formulate the DFSM vision for the campaign. For more information or to contribute please contact Dr. Janet Townsend at (718) 920-2819 or via e-mail at [email protected]. Montefiore Maternal and Child Health Summer Mentoring Program. We are getting ready to host a group of 12 high school and college students interested in health careers for our six-week program. Sharon Lawrence and Jennifer Ayala, who recently graduated from MIT and Wesleyan, respectively have joined us as coordinators for the summer program. Sharon is from the Williamsbridge neighborhood and Jennifer is from Hunts Point. Jennifer and Sharon are participating in internships sponsored by Health Career Connections (HCC). Erica Acosta, an NYU nursing student from our 2005 class, was featured in a profile in the Daily News on June 5 and reported that a shadowing experience she had in our program was instrumental in her career choice. We hosted a group of HCC interns on June 15 for a workshop on cultural competence, led by Janet Townsend. For more information on this program please contact Carol Whittaker at (718) 920-6283 or via e-mail at [email protected]. Clark WH, Gold M, Grossman D, Winikoff B. Can mifepristone medical abortion be simplified? A review of the evidence and questions for future research. Contraception 2007; 75:245-250. Cunningham C. Do-Good Doc: A young African American MD hopes her research will end discrimination against poor folks with HIV in the health care system. Housing Works 2007. Available at http://www.hwupdate.org/update/2007/05/dogood_doc.html Dyche L. Interpersonal skill in medicine: the essential partner of verbal communication. Journal of General Internal Medicine 2007;22(7):1035-9. Dyche L. Narrative Medicine: All My Children. Families, Systems and Health 2006; 24(4):487-8. Ozuah PO, Reznik M, Braganza SF. Assessment of residents’ competency in asthma severity classification. Medical Education. 2007:41(5):524-525. Selwyn PA. Small Victories. JAMA 2007: 297(22); 24552456. Congratulations! To Drs. Darwin Deen and Lisa Hark on the publication of the Complete Guide to Nutrition in Primary Care which aims to assist primary care clinicians in incorporating nutrition into routine patient care. The book covers nutrition assessment and therapy for the most common medical conditions seen in the primary care setting. With the epidemic of obesity and its associated medical consequences, including heart disease, hypertension, diabetes, and cancer, clinicians need to be able to assess and counsel patients about their diet and lifestyle on a daily basis. For more information please visit www.drdeen.com. HAVE A HAPPY AND SAFE SUMMER!! -5- Schedule Highlights The Hispanic Center of Excellence and Bronx Center to Reduce & Eliminate Ethnic & Racial Health Disparities (Bronx CREED) Advanced Workshop on Case-Based Cross-Cultural Teaching By Debbie Salas-Lopez, MD, MPH Chief-General Internal Medicine Lehigh Valley Health and Hospital Network Date: September 18, 2007 Time: 8:00 AM to 12:00 PM Place: Nurses Building, Conf Rm For information contact Hope Spano at (718) 430-2792 or via e-mail at [email protected] NY’s Best Doctors 2007 Congratulations! To all the physicians affiliated with our department who are noted as one of New York Magazine’s Best Doctors in New York for 2007, in the June 18 issue. Physicians listed include: John Cahill Neil Calman Albert Levy Robert Morrow Robert Schiller Peter Selwyn Bruce Soloway Steven Tamarin DFSM Newsletter is produced by the Department of Family and Social Medicine at Montefiore Medical Center Managing Editor/Designer: Tami Lee Rivera - [email protected] FAMILY MEDICINE We are pleased to announce that Dr. Lisa Baron has assumed the role of Associate Residency Director for Family Medicine as of June. Dr. Baron received her MD from Mt. Sinai School of Medicine and completed her residency in Family Medicine at the RPSM, during which time she had her continuity practice at the Family Health Center. Dr. Baron has been a provider at West Farms Family Practice where she coordinated the medical students during their Family Medicine clerkship. Dr. Baron served as the Associate Director of our Family Medicine inpatient unit from 2001 to June 2007. In that role she was instrumental in organizing a high quality teaching series on inpatient medicine for our residents. She played a key role in creating and implementing our July month Orientation for new PGY 1’s. She has served on our Family Medicine QI Committee and worked with Dr. Guilbe to systematically review and improve the quality of care for patients and education for residents on our inpatient service. She has advanced certification in Palliative Care and serves as an attending on our inpatient Palliative Care Service. In her new role as Associate Residency Director, Dr. Baron has relocated her continuity practice back to the Family Health Center. She will precept residents at both FHC and Williamsbridge. As the Associate Residency Director, she will assist with the management and maintenance of the overall residency curriculum including its systemic review and revision. She will provide support to Faculty Team Leaders with resident advising, assessment and the development and implementation of resident learning plans. She will coordinate and supervise new resident recruitment and selection. Dr. Baron will also, supervise and oversee the coordination of our Family Medicine Tuesday afternoon didactic teaching sessions. Dr. Baron is a beloved and highly respected colleague, teacher and clinician and we are privileged to have her in this new role within the residency. Her talent, intelligence, calm demeanor, attention to detail and witty sense of humor will greatly benefit our program. To quote Dr. Gorski, Dr. Lisa Baron is “a clinician’s clinician, a humanist, a teacher, a leader among family physicians committed to care in urban underserved communities.” Dr. Baron can be reached at (718) 920-2892 or via e-mail at [email protected]. Please join us in extending loud and happy CONGRATULATIONS to Dr. Lisa Baron as she begins her new role! -6-
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